Healthcare Provider Details

I. General information

NPI: 1013056001
Provider Name (Legal Business Name): JENNIFER M GARCIA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JENNIFER M MAITO M.D.

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 EL CENTRO FAMILIAR BLVD SW
ALBUQUERQUE NM
87105-4592
US

IV. Provider business mailing address

800 BRADBURY DR SE STE 116
ALBUQUERQUE NM
87106-4310
US

V. Phone/Fax

Practice location:
  • Phone: 505-873-7400
  • Fax: 505-224-8797
Mailing address:
  • Phone: 505-272-1476
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD2009-0169
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: